Resident asks for improved stroke care (with WMH response)

Editor's Note: This township meeting story appeared in the March 5th News Eagle and was followed on March 12 by a story containing a response from Wayne Memorial Hospital (WMH) officials. In the online edition, the township story inadvertently was posted to or web site AFTER the hospital's response. This updated version corre...

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By Katie CollinsNews Eagle ReporterFollow Katie @Neaglereporter

News Eagle - Hawley, PA

By Katie CollinsNews Eagle ReporterFollow Katie @Neaglereporter

Posted Mar. 13, 2014 at 1:43 PM

By Katie CollinsNews Eagle ReporterFollow Katie @Neaglereporter

Posted Mar. 13, 2014 at 1:43 PM

LACKAWAXEN

A resident of Fawn Lake, Sally Whalem said at the February 24th Lackawaxen Township meeting that she was concerned that there isn't a proper facility to handle stroke victims in the area. Although an ambulance may help a stroke patient, she said they can only stabilize the person. Because Wayne Memorial doesn't have the proper facilities, Whalem told the Board, “If someone has a massive stroke, they're dead.” Looking to the Board for help, Whalem said she would be willing to go with whomever to the hospital, to talk about how Wayne Memorial could get a stroke facility and get the hospital, “up to snuff.”

Although he was not representing the hospital, AJ Manzione from Lackawaxen Volunteer Ambulance, told the public that Wayne Memorial is working on a program. Manzione said he works in the hospital's computer department and although he is not sure where the process of the project is, he said there is, “something in the works to treat stroke patients.”

RESPONSE FROM WAYNE MEMORIAL HOSPITAL:

In an effort to reassure the public that Wayne Memorial Hospital can help stroke patients, the Director of Patient Care Services James (Jim) Pettinato, BSN, MHSA, RN and the Public Relations Manager Lisa Champeau recently spoke with The News Eagle about a few developments happening in the hospital.

Currently, WMH is in the process of becoming a certified stroke center. Although hospitals in Pennsylvania aren’t required to be accredited, Champeau said WMH is “very close.”

Despite not being stroke certified, Pettinato said the hospital follows all of the stroke guidelines. Now, he said the hospital is able to administer the appropriate medication to treat acute patients. But the hospital is, “going for the extra steps,” which will “bring a whole component of quality and assurance.” With the accreditation, Pettinato said there won’t be many changes regarding the, “stroke care arena.”

In a matter of three hours, ischemic stroke patients must receive the only FDA approved drug that is a, “clot buster,” said Champeau. For ischemic strokes, Pettinato explained that the person is already bleeding and that needs to stop. Even with medication, he said there is only a “narrow window of opportunity to help dissolve the clot.” Time, is of the essence because “time is brain tissue,” which he said the faster the vessel is opened, the less damage there will be.

There is no drug for the hemorrhagic stroke. When that occurs, Champeau said “things get really dicey,” because of the potential need for surgery. Pettinato said most emergency rooms can take care of life threatening situations, that occur with the ischemic and or hemorrhagic stroke, but he added that it is very important that people recognize the warning signs of a stroke and get help quickly.

Page 2 of 3 - The process of accreditation at WMH is moving along Pettinato said, and the accrediting company, DNV GL Healthcare’s next visit should finalize the hospital's accreditation sometime between June and September.

An important element to having a stroke center, Pettinato said is public education. By making people aware of the signs and symptoms of a stroke, WMH is trying to “communicate a very simple message,” about the significance of time. In addition to a stroke, he said there are other life threatening situations that can occur secondary to the stroke.

Champeau said WMH is also working with Geisinger Community Medical Center of Scranton and Geisinger Medical Center in Danville to establish “telestroke.” A two-way communication, telestroke will allow physicians to see and assess patients at other hospitals. With the telestroke, neurologists will be available around the clock. Now, doctors are dependent on the evaluations of emergency room physicians when communicating by phone. By seeing the patient, she said doctors can consult with the patients.

WMH already has the equipment, but a telecommunication line still has to be established. The reason for the wait, Pettinato explained is that it needs to be a very broad-band communication for a “real time image.” Champeau said WMH basically has an agreement in place with Geisnger, and the neurologists have been credentialed. Literally, Pettinato said, “somebody needs to terminate the connections.”

The telestroke equipment, Pettinato said was “collectively just under $40,000.” But there will be a continuing expense for the telecommunications line. Considering the number of lives that will be saved, Champeau said the cost really isn’t that much.

The telestroke, Pettinato said is the hospital’s first “endeavor into telemedicine.” Telemedicine, he said is a “vital link for community hospitals,” as it allows for a connection to other care services. Once the lines are established for the telstroke, he said telemedicine will be expanded for anything that requires tertiary care. Telstroke was first however, Pettinato said because there is a “high level of need,” and it’s an initiative by the American Stroke Association. Once the equipment is setup, he said the “possibilities are endless,” because of the round the clock assistance that can help other conditions.

According to an internal analysis, Pettinato said WMH misses six to 10 patients per month, that could receive the medication, because they miss the three hour timeframe. Typically, only two to three patients receive the medication. He said its, “disheartening,” to see the patients arrive too late.

Education, Pettinato said is very important because the hospital has found that the public is not fully aware of the signs and symptoms of a stroke. In part, because people ignore the warning signs as they may not realize that the symptoms can occur days or even months before the stroke occurs.

Page 3 of 3 - As a certified stroke center, WMH will have to collaborate with the emergency medical service volunteers in the region, to provide educational sessions about what stroke related management WHM does. Pettinato said the volunteers are not just people transporters, as they are part of the stroke team.

Pettinato said from a patient’s perspective, once WMH is accredited, not much will change as there is no new therapy or process. Instead, there’s just something that says the hospital is following the appropriate standards.

With the new resources, Pettinato said stroke care is “pretty well defined,” as it is “basically a black and white situation.”

STROKE WARNING SIGNS

• Sudden numbness or weakness of the face, arm or leg, especially on one side of the body

• Sudden confusion, trouble speaking or understanding

• Sudden trouble seeing in one or both eyes

• Sudden trouble walking, dizziness, loss of balance or coordination

• Sudden severe headache with no known cause.

To learn more:

• Talk to your doctor, nurse or other healthcare professionals. Ask about other stroke topics.

• Call 1-888-4-STROKE (1-888-478-7653) or visit StrokeAssociation.org to learn more about stroke.